Healthcare Provider Details

I. General information

NPI: 1952425159
Provider Name (Legal Business Name): FAMILY PHYSICIANS OF COLUMBUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 RIVER RD SUITE 101
COLUMBUS GA
31904-3352
US

IV. Provider business mailing address

6801 RIVER RD SUITE 101
COLUMBUS GA
31904-3352
US

V. Phone/Fax

Practice location:
  • Phone: 706-494-0694
  • Fax:
Mailing address:
  • Phone: 706-494-0694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. JAMIE BONNER LEWIS
Title or Position: OFFICE MANAGER
Credential: RN
Phone: 706-494-0694